Transplantation proceedings · 2025
A Novel Visible Method for Monitoring Kidney Rejection: Homologous Donor-Derived Sentinel Skin.
СтатьяНазвание и аннотация: Перевод в очереди
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Rong Xiangke, Wang Kai, Tang Jiezhang, Yang Jizhong, Wang Huilong, Liu Kepu, Li Zhibin, Li Jing, Zhang Geng, Yi Chenggang
Аннотация
BACKGROUNDS: Rejection in facial transplant patients is always accompanied by changes in skin appearance and can be monitored by observation of the skin. Acute rejection (AR) after kidney transplantation has a significant impact on the function of the transplanted kidney, which is relatively difficult to monitor. In this study, the skin of the same donor was used as a sentinel for monitoring the rejection of kidney transplantation.
METHODS: A 3 cm × 5 cm skin was procured from the kidney donor and was grafted to the recipient at the same time as the kidney transplantation, to serve as a sentinel for monitoring AR. Postoperatively, kidney rejection was monitored by observing changes in the appearance of the sentinel skin (SS). The safety of this procedure was also evaluated by comparing the renal function in 12 patients in the sentinel skin graft group and 20 patients with kidney transplantation alone.
RESULTS: The same immunosuppressive regimen was used postoperatively in patients with SS transplantation and those with kidney transplantation merely. There was also no statistical difference in creatinine and urea nitrogen between the 2 groups (P > .05), but a difference in urine protein (UP) (P < .05) in 2 weeks, 1and 2 months, which was lower in the test group, and no difference in 3 months. In addition, 1 patient had changes in the SS indicating rejection, while creatinine was normal at that time, which was followed by SS and kidney biopsy, suggesting both were of different grades of rejection.
CONCLUSIONS: SS combined with simultaneous kidney transplantation is a safe and feasible surgical approach. In particular, The SS holds promise for monitoring rejection and also sub-clinical rejection.
METHODS: A 3 cm × 5 cm skin was procured from the kidney donor and was grafted to the recipient at the same time as the kidney transplantation, to serve as a sentinel for monitoring AR. Postoperatively, kidney rejection was monitored by observing changes in the appearance of the sentinel skin (SS). The safety of this procedure was also evaluated by comparing the renal function in 12 patients in the sentinel skin graft group and 20 patients with kidney transplantation alone.
RESULTS: The same immunosuppressive regimen was used postoperatively in patients with SS transplantation and those with kidney transplantation merely. There was also no statistical difference in creatinine and urea nitrogen between the 2 groups (P > .05), but a difference in urine protein (UP) (P < .05) in 2 weeks, 1and 2 months, which was lower in the test group, and no difference in 3 months. In addition, 1 patient had changes in the SS indicating rejection, while creatinine was normal at that time, which was followed by SS and kidney biopsy, suggesting both were of different grades of rejection.
CONCLUSIONS: SS combined with simultaneous kidney transplantation is a safe and feasible surgical approach. In particular, The SS holds promise for monitoring rejection and also sub-clinical rejection.